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Updated: Jul 20, 2026
Multifocal Electroretinograms
Published on: December 4, 2011
Post-fever Retinitis With a Positive Weil-Felix Test: A Study From a Tertiary Center in South India
Vivek Wani1, Arvind Tenagi1, Shivanand C Bubanale1
1Department of Ophthalmology, Jawaharlal Nehru Medical College, Belagavi, IND.
Abstract:
Background Post-fever retinitis (PFR) is reported two to six weeks after fever and affects one or both eyes. Rickettsial fever is one of the most common causes of PFR. This study aimed to report the clinical features and treatment outcomes of PFR cases with a positive Weil-Felix test. Methodology In this study, we collected demographic data, fever details, eye symptoms, ocular examination findings, optical coherence tomography (OCT) and fundus fluorescein angiography findings, laboratory findings, and length of follow-up of consecutive PFR cases with a positive Weil-Felix test. All cases were treated with oral doxycycline and prednisolone. Final best-corrected visual acuity (BCVA) and ocular examination findings were recorded. Visual field examination and follow-up OCT results were noted if available. Results A total of nine patients (eight males) with a mean age of 39.1 years with fever before ocular symptoms and positive Weil-Felix test were included. Six patients had bilateral disease. The mean initial and final BCVA in the affected eyes was 1.16 and 0.35 logMAR units, respectively (p < 0001). All 15 eyes had typical white retinitis patches and retinal hemorrhages which resolved after treatment. OCT showed hyperreflectivity and inner retinal disorganization over retinitis patches. White subretinal lines were noted in three patients and retinal nerve fiber bundle defect with corresponding visual field defect was seen in one eye. Conclusions In this study, PFR due to rickettsia infections has been reported from our region for the first time. Hence, eye specialists in the region should be aware of this entity.
Insights
Post-fever retinitis (PFR) linked to rickettsial infections can cause vision loss. Early treatment with doxycycline and prednisolone significantly improved visual acuity in affected eyes.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Retinal Diseases
Background:
- Post-fever retinitis (PFR) is an ocular condition occurring weeks after a febrile illness.
- Rickettsial infections are a frequent cause of PFR, impacting one or both eyes.
Purpose of the Study:
- To describe the clinical characteristics and treatment outcomes of PFR patients with positive Weil-Felix tests.
- To raise awareness among ophthalmologists in the region about this rickettsia-associated entity.
Main Methods:
- Retrospective collection of demographic, clinical, and laboratory data from PFR patients with positive Weil-Felix tests.
- Ocular examination, optical coherence tomography (OCT), and fundus fluorescein angiography were utilized.
- Treatment involved oral doxycycline and prednisolone, with outcomes assessed by best-corrected visual acuity (BCVA) and follow-up imaging.
Main Results:
- Nine patients (mean age 39.1 years) with fever preceding ocular symptoms and positive Weil-Felix tests were included; six had bilateral PFR.
- Mean BCVA improved significantly from 1.16 to 0.35 logMAR units (p < 0.001) after treatment.
- All affected eyes showed resolution of retinitis patches and hemorrhages; OCT revealed inner retinal disorganization and hyperreflectivity.
Conclusions:
- This study reports PFR associated with rickettsia infections in the region for the first time.
- Ophthalmologists should consider rickettsial causes in patients presenting with PFR.
- Prompt treatment with doxycycline and prednisolone can lead to significant visual recovery.
